Claims Processor

Job Summary:

CVS Health is seeking a skilled Claims Processor to join our Claims Department. As a Claims Processor, you will be responsible for accurately and efficiently adjudicating paper claims from electronic images in a production environment.

Key Responsibilities:

• Outbound calls to Members and/or Providers for verification of information
• Processing and adjudicating paper claims
• Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures
• Accurately resolving pending claims using state and federal regulations and specific health plan criteria
• Working within turnaround times to meet client performance guarantees for claims processing
• Meeting productivity and accuracy standards

Requirements:

• At least 1 year of work experience that shows a progressive trend in responsibility and accountability preferably in a Healthcare setting
• Excellent verbal and written communication skills
• In-depth experience working with Microsoft Office Suite products

Preferred Qualifications:

• Call center type experience
• Previous PBM Experience
• Strong typing skills with speed and accuracy
• Team-oriented while also able to pursue personal and departmental production goals daily
• Ability to stay organized in a multi-demand and multi-priority environment
• Ability to work overtime as necessary

Benefits:

• The Company offers a full range of medical, dental, and vision benefits
• Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees
• The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits
• CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners

Additional Information:

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.